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118 Consultant-level reporting of key performance indicators within the health insurance industry: a study assessing feasibility and impact on accountability, cost efficiency, and quality of care
  1. Olga Chalupczak,
  2. Epaminondas Sourlas,
  3. Ayodele Kazeem,
  4. Alice Duggan,
  5. Francesca Toffolo-Staines,
  6. Julie Konfortion
  1. Bupa, London, UK

Abstract

Objective The impact of transparency, the sharing of data, within the healthcare industry has been investigated at great length, specifically in the domains of accountability, cost efficiency, and quality of care. Bupa is commited to putting our customer’s best interests, health, and well being at the heart of everything we do, including maintaining the affordability of high-quality healthcare. In order to bridge the gap in information asymmetry, Bupa recently launched a pilot in which a group of consultants are provided with monthly dashboards containing personalised information on Key Performance Indicators (KPI). The KPI dashboard identifies unwarranted variation in clinical practice, highlighting areas for potential performance improvement.

Method The KPI dashboard is composed of 2 sections: the first displaying a breakdown of recent activity attributed to the consultant, whilst the second provides a detailed insight into specific performance indicators, including peer-to-peer comparison. The measures used focus on utilisation rates (diagnostics, pathology, surgery, imaging etc.) and the cost efficiency of healthcare delivery.

Consultants from four specialties (Ear, Nose and Throat, Ophthalmology, Cardiothoracic Surgery, and Urology) are partaking in the pilot. Consultants displaying sustained improvement in practice will be eligible to join Bupa’s Open Referral Consultant Network. Following a period of 12 months the pilot will be evaluated operationally, financially, and clinically.

Operational feasibility of providing the dashboards to consultants and addressing consultant queries is to be assessed on a scale of light, medium, and heavy touch; these have reducing levels of interaction (face-to-face, phone, email) with Bupa field team employees and Medical Directors.

Results The pilot was launched January 2018 and changes in consultant practice are not yet visible within the claims data, however preliminary trends will be visible by August 2018. 82% of consultants responded to the invite to join the pilot, of which 86% have subsequently agreed to participate. Early indications suggest that the consultants are engaged and interested in understanding their data and how it compares to that of their peers.

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